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      A case of orbital sebaceous gland carcinoma developing in an anophthalmic socket 65 years after enucleation

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          Abstract

          Although conjunctival squamous cell carcinoma is known to develop as a result of chronic irritation from wearing an ocular prosthesis, orbital sebaceous gland carcinoma arising in an anophthalmic pocket is extremely rare. We report a 68-year-old female who developed a sebaceous gland carcinoma 65 years after her right eye was enucleated (at the age of three years) due to congenital glaucoma. The patient had noticed increasing discharge and swelling of her right eyelid. Incisional biopsies of an underlying orbital mass revealed poorly differentiated sebaceous gland carcinoma. The sebaceous gland carcinoma in this case could have been caused by chronic irritation as a result of long-standing use of a poorly fitted ocular prosthesis. The current case of a malignant tumor occurring 65 years after enucleation emphasizes the importance of long-term clinical surveillance to monitor for tumor formation. Careful examination of the anophthalmic socket should be part of the physical examination.

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          Most cited references19

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          Sebaceous carcinoma of the ocular region: a review.

          Sebaceous carcinoma of the ocular region is a malignant neoplasm that is being recognized more frequently and managed by innovative techniques of local resection, cryotherapy, topical chemotherapy, and radiotherapy, resulting in improved visual and systemic prognosis.
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            Sebaceous carcinoma of the eyelids: thirty cases from Japan.

            Sebaceous carcinoma of the eyelids is rare in Western countries but not uncommon in Asian countries. Diagnosis is difficult both clinically and histologically. Thirty cases of sebaceous carcinoma of the eyelids treated at Tokyo Medical University Hospital were reviewed to elicit characteristic features of pathological findings. The tumor cells were infiltrating in a lobular pattern that consisted mainly of large atypical germinative cells. Sebocytes seen in the lobules had conspicuous nucleolus associated with perinucleolar halo. In 17 cases (57%) there was foamy histiocyte infiltration in and around the tumor nests. Sebaceous duct differentiation, namely holocrine secretion indicating a specific type of coagulation necrosis maintaining a cellular framework or maintaining a bubbly cytoplasm associated with nuclear debris in the periphery, was seen in 24 cases (80%). Although unequivocal squamous differentiation was limited to only 11 carcinomas, scattered individual necrosis with nuclear debris in the background of germinative cells appeared in 29 cases (96.7%). Expression of epithelial membrane antigen, perilipin and adipophilin were detected in all cases. In conclusion, to detect sebaceous differentiation in sebaceous carcinoma, it would be helpful to focus on holocrine secretion, squamous differentiation and foamy macrophage infiltration, and to utilize immunohistochemistry involving anti-perilipin and anti-adipophilin stain.
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              Conjunctival squamous cell carcinoma in the anophthalmic socket.

              To describe 2 patients in whom squamous cell carcinoma of the conjunctiva developed in the anophthalmic socket more than 44 years after enucleation and chronic use of an ocular prosthesis.
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                Author and article information

                Journal
                Clin Ophthalmol
                Clin Ophthalmol
                Clinical Ophthalmology
                Clinical Ophthalmology (Auckland, N.Z.)
                Dove Medical Press
                1177-5467
                1177-5483
                2013
                2013
                16 September 2013
                : 7
                : 1825-1827
                Affiliations
                [1 ]Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan
                [2 ]Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo, Japan
                [3 ]Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
                Author notes

                *These authors contributed equally to this work

                Correspondence: Motoko Shibata, Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan, Tel +81 3 3346 1696, Fax +81 3 3346 9170, Email takizawamotoko.327@ 123456hotmail.co.jp
                Article
                opth-7-1825
                10.2147/OPTH.S44639
                3783503
                24072963
                3311f1cf-1502-42c5-a893-fb49a12eedfc
                © 2013 Shibata et al, This work is published by Dove Medical Press Ltd, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License

                The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Ltd, provided the work is properly attributed.

                History
                Categories
                Case Report

                Ophthalmology & Optometry
                sebaceous gland carcinoma,anophthalmos,orbit
                Ophthalmology & Optometry
                sebaceous gland carcinoma, anophthalmos, orbit

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